Waiting times have been a central concern in the English NHS, where care is provided free at the point of delivery and is rationed by waiting time. Pro-market reforms introduced in the NHS in the 1990s were not accompanied by large drops in waiting times. As a result, the English government in 2000 adopted the use of an aggressive policy of targets coupled with publication of waiting times data at hospital level and strong sanctions for poor performing hospital managers. This regime has been dubbed 'targets and terror'.

Across England, patients are beginning to use the new 'choose and book' system to select the location of their hospital care. But will the affluent be more likely to exercise choice than people from more deprived areas?

Recent health care reforms are paving the way for greater competition between providers of health care, both within and outside the NHS - which the government believes will promote greater responsiveness of hospitals to patients' needs, cut waiting lists and reduce equity in the receipt of health care. But as Professor Carol Propper points out, the evidence to support these claims is by no means unequivocal. 'The devil is in the detail', she argues: the impact of competition in health care markets depends on the precise nature of the policies introduced and the interaction between them.